Marissa Michael Mack, CNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

17067 Issued in OH

Practice address

6780 Mayfield Rd
Mayfield Heights, OH 44124-2203

Phone

(440) 312-4500

NPI assigned

Feb 17, 2015

Last updated

Feb 17, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ravi Krishnan MD LLCGroup PAC ID 1456718469, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hillcrest Hospital Hospital, Mayfield Heights, OH, CCN 360230
• Cleveland Clinic Hospital, Cleveland, OH, CCN 360180

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmack1269431@direct.ccf.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ravi Krishnan MD LLC

  • Internal Medicine Physician
  • Mayfield Village, OH
  • NPI 1043915770
  Medicare reassignment Care Compare group NPD
• Atrium Medical Group, Inc

  • Specialist
  • Willoughby, OH
  • NPI 1851340822
  Medicare reassignment NPD
• Euclid Hospital Cleveland Clinic Health System

  dba cleveland clinic foundation

  • General Acute Care Hospital
  • Euclid, OH
  • NPI 1457403016
  NPD
• Mukunda Medical Group LLC

  • Internal Medicine Physician
  • Mayfield Village, OH
  • NPI 1578267647
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cleveland Clinic Health System - East Region

  dba Hillcrest Hospital

  • General Acute Care Hospital
  • Mayfield HTS, OH
  • NPI 1902858152
  Care Compare affiliation
• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1424131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424131200000",
    "number": "1497146195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6559 WILSON MILLS RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441436402",
            "telephone_number": "440-449-1540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6780 MAYFIELD RD",
            "city": "MAYFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441242203",
            "telephone_number": "440-312-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "MARISSA",
        "middle_name": "MICHAEL",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-17",
        "last_updated": "2015-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "17067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Lieberman
• Danielle Kristine Lindberg, D.O.
• Taban Lotfi
• Madelene Eve Lussier, PA-C
• Cara Ann Lyle, M.D.
• Jennifer K Mackey, CNP
• Erica Susanne Majernik, NNP-BC
• Simee I Malik, MD
• Jane F Manno, PSY.D
• Manor Care of Mayfield Heights Oh LLC (ManorCare Health Services - Mayfield Heights)

• Adult Health Nurse Practitioner in Mayfield Heights, OH
• Providers in Mayfield Heights, OH by specialty
• Adult Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.